December 28, 1997 in Nation/World

Clinic A Godsend To Poor Health-Care Volunteers Enjoy Serious Mission

By The Spokesman-Review
 

Staff camaraderie is one thing that keeps counselor Skip Frazier volunteering at Lake City Health Care, where humor belies a serious mission.

“It’s fun to be around here,” he said of the clinic, which looks after the Panhandle’s poor. “Everyone’s real supportive. Except for the pharmacist.”

With that he sent a joking glance toward Kathy Ream, who donates her time to dispense drugs. She made a funny face.

The stalwart group of volunteers, a dauntless director and community support have made the clinic a fixture on the Panhandle health scene.

After years of carrying medicines around in baskets and working out of a borrowed office, it has a permanent home and plans to expand its hours beyond two evenings a week.

“It’s really a wonderful thing that they do,” said Fay Brumbaugh of Rathdrum, who was waiting while her husband was examined at the clinic last Tuesday. He has high blood pressure and heart problems.

Brumbaugh makes $6 an hour as a nursing home kitchen worker. Buying insurance is out of the question.

“It would cost me $150 a month,” she said, “I just can’t afford it.”

The suffering of uninsured and underinsured people was what inspired the creation of the clinic in 1989. It was the brainchild of Lidwina Dirne and Sandy Mamola, two Catholic women deeply involved in welfare issues.

“As far as I know, in the entire state, we’re the only clinic like this that doesn’t take federal money,” said Mamola, the executive director.

The clinic’s board of directors decided long ago not to accept federal dollars. That could change, but Mamola said she doubts it.

“The No. 1 reason is our belief that we should be able to do this ourselves - the community, churches, local government.”

Federal dollars require a lot of paperwork and come with too many strings attached, Mamola added. If for example, a patient’s income rises for just one month, the clinic wants to have the flexibility to continue helping him or her.

The clinic’s annual budget is less than $100,000. The two counties that contribute are Kootenai and Bonner, which give $30,000 and $15,000, respectively. People drive from as far away as Boundary County seeking help.

Lake City Health Care is a model for the Panhandle’s second low-income clinic, which will open in January. It will be based in the Panhandle Health District office in Kellogg.

Until last July, Lake City Health Care operated out of the health district’s Coeur d’Alene offices.

Then its clinic moved into the basement suite of 1111 Ironwood Drive, the heart of the Coeur d’Alene medical district. Kootenai Medical Center pays the lease and the utilities.

Reaching out to the poor “is a very important part of the mission of the hospital,” explained Jim Faucher, KMC’s vice president for community development.

KMC has donated lab services and medicines to the clinic since its earliest days. Faucher hopes the clinic eventually will be able to offer dentistry.

Faucher said he had no doubt that the clinic would be a success, although it took years to get it off the ground.

“If you know Sandy Mamola, if you know the tenacity of those individuals involved….”

Mamola is a high-energy woman who jokes that she’ll beg, borrow or steal to get supplies and volunteers. Friends vouch for all but the stealing.

At first, some local doctors resisted the idea of the clinic. Some didn’t think it was needed. One doctor told organizers they were just doing the charitable work because it made them feel good.

“He had us there,” Mamola said.

Dr. Stuart Denny, who has volunteered since the beginning, describes those who have stuck with the clinic as “faith-driven people.” He’s gratified that support for their effort is growing in the medical community. He’s not sure why more doctors don’t pitch in, though.

“I really had high hopes that most of the doctors would volunteer once every three or four months,” he said.

Thirteen doctors regularly volunteer. Most are family practitioners, of which there are about 60 in the Coeur d’Alene area.

Mamola frets about asking too much of volunteers, who do everything from taking financial statements to taking temperatures.

“I always worry I’m going to burn them out, and I’ll never see them again,” Mamola said.

Dr. Terry Riske appreciates that attitude.

“They are very much mindful of the fact that all of us put in a full day before we go there,” Riske said. Although he goes home dead tired after his volunteer shift, he said, “I honestly have not found it burdensome because they treat you so well.”

He also likes the fact that Lake City Health Care screens the patients.

“You’re not seeing someone who’s trying to manipulate the system or get medications they shouldn’t be getting.”

The volunteer doctors must treat patients with a limited supply of donated drugs.

“The doctors, say, ‘You challenge us,”’ said volunteer Peggy Irving, a retired nurse and longtime volunteer. “They have to look at what does this cost, isn’t there a cheaper drug that would work just as well?”

They find solutions to most problems. Ninety-three percent of the patients don’t need referrals to specialists.

The doctors are touched by the neediness of some of the folks who go to the clinic.

“A gentleman (who) came in there not too long ago was living in a cardboard box out in the national forest somewhere. He had no heat source, no running water, no nothing,” Denny said. “We ended up sending him to a men’s shelter in order to get well.”

Most patients have homes. They just can’t afford health care. Todd Fencl, a Hayden Lake janitor, scrapes together $85 a month to pay for his daughter’s insurance. But the policy has a $500 deductible. He has no coverage for himself or his wife, April.

This week, 13-month-old Wendi had a double ear infection and her mother had bronchitis. The family couldn’t afford to buy medicine.

Fencl was distraught to learn that Wendi had outgrown her benefits under Medicaid, which has complex qualification rules.

“I’d like to see the welfare department get by on what I make,” he said as the family sat in the waiting room of Lake City Health Care.

Such frustration breeds hopelessness. According to Frazier, 60 to 80 percent of the people who are referred to Lake City Health Care for counseling have some form of depression.

Other ailments range in severity from colds to terminal cancer. The clinic averages 55 patients a week. Mamola expects that number to grow.

“My vision is to open two daytime clinics a week and one night-time clinic,” she said.

To accomplish that, she wants to hire a nurse practitioner for the day shifts. She’s having trouble finding one who wants the part-time job and will accept the clinic’s low wages.

“It’s going to be a special person,” she said. “It’s a ministry job. That’s what it is for everyone here.”

Mamola makes $24,000 a year and works 30 to 50 hours a week.

One of her toughest tasks is sending some patients home untreated when their numbers overwhelm the number of people available to see them.

Nearly everything else Mamola does has an element of fund raising. Sometimes, she fears that the clinic is a well-kept secret.

“I wish we were as well-known as Children’s Village,” she said. “I wish people knew they could give us money at Christmas, too.”

Still, she’s buoyed by the amount of support the clinic gets, and the progress it has made.

“It’s been quite a journey.”

, DataTimes ILLUSTRATION: Color photo

MEMO: This sidebar appeared with the story: LAKE CITY HEALTH CARE The clinic, 1111 Ironwood Drive, treats people who have low incomes and no medical insurance. It is open Tuesdays and Thursdays beginning at 5:45 p.m. Patients are asked to bring proof of income for the past 30 days. They will be charged $1 to $10; after Jan. 1, the minimum payment will increase to $5. The clinic does not treat sexually transmitted disease, lacerations or fractures; or give pregnancy tests or provide routine gynecological care.

This sidebar appeared with the story: LAKE CITY HEALTH CARE The clinic, 1111 Ironwood Drive, treats people who have low incomes and no medical insurance. It is open Tuesdays and Thursdays beginning at 5:45 p.m. Patients are asked to bring proof of income for the past 30 days. They will be charged $1 to $10; after Jan. 1, the minimum payment will increase to $5. The clinic does not treat sexually transmitted disease, lacerations or fractures; or give pregnancy tests or provide routine gynecological care.


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